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Background. Since the start of the COVID-19 pandemic, Chad has had 7,417 confirmed cases and 193 deaths, one of the lowest in Africa. Objective. This study assessed SARS-CoV-2 immunity in N'Djamena. Methods. In August-October 2021, eleven N'Djamena hospitals collected outpatient data and samples. IgG antibodies against SARSCoV- 2 nucleocapsid protein were identified using ELISA. "Bambino Gesu" Laboratory, Rome, Italy, performed external quality control with chemiluminescence assay. Results. 25-34-year-old (35.2%) made up the largest age group at 31.9 12.6 years. 56.4% were women, 1.3 women/men. The 7th district had 22.5% and the 1st 22.3%. Housewives and students dominated. Overall seroprevalence was 69.5% (95% CI: 67.7-71.3), females 68.2% (65.8-70.5) and males 71.2% (68.6-73.8). >44-year-old had 73.9% seroprevalence. Under-15s were 57.4% positive. Housewives (70.9%), civil servants (71.5%), and health workers (9.7%) had the highest antibody positivity. N'Djamena's 9th district had 73.1% optimism and the 3rd district had 52.5%. Seroprevalences were highest at Good Samaritan Hospital (75.4%) and National General Referral Hospital (74.7%). Conclusion. Our findings indicate a high circulation of SARS-CoV- 2 in N'Djamena, despite low mortality and morbidity after the first two COVID-19 pandemic waves. This high seroprevalence must be considered in Chad's vaccine policy.
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Background: Evolution evidence of Coronavirus disease 2019 (COVID-19) and viral clearance time remains limited in tropical settings. Understanding this is crucial for public health control measures at community-level. We evaluated the viral dynamics of SARS-CoV-2 infection and factors associated with positivity duration in COVID-19 cases in Cameroon. Method(s): We conducted a prospective cohort-study of SARS-CoV-2 positive cases from the first to third wave (March 2020-October 2021) in Yaounde- Cameroon. RT-PCR was performed on nasopharyngeal swabs. SARS-CoV-2 positivity duration was evaluated from the first to last positive test before a negative result. Epi-info V.7.0 was used for data analyses with p< 0.05 considered statistically significant Results: A total of 282 participants were enrolled. The mean age was 41+/-14 years, with male predominant (62.1%). We had 15.6% symptomatic cases and cough most common (59.09%). The overall median positivity duration was 15[IQR: 9-23] days with 15[ IQR: 13-16] in the first, 17[ IQR: 11-26] in the second and 8[ IQR: 4-12] in the third wave (p= 0.007). Positivity duration was significantly higher in males (16 versus 14 days, p=0.03) and people aged >40 years (15 versus 14 days, p=0.02). Positivity duration was not affected by presence or absence of symptoms (p=0.80). No significant correlation was found with viral load (r=0.03;p=0.61). Considering baseline (24.7+/-7.2Ct) and last viral load (29.3+/-5.9 Ct), the DELTACt (4.6+/-1.3) and positivity duration (15 days) revealed a kinetic in viral decay of 0.3+/-0.087 Ct/day. Conclusion(s): A median positivity duration of 15 days is in accordance with viral clearance around 2 weeks for optimal confinement at community-level. Men and/or the elderly stand at higher risk of prolonged infection. Given the viral decay (0.3 Ct daily), we suggest personalized confinement periods. The variability of positivity duration according to phases could be function of strains which could be a factor of positivity duration.
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Background: Children seem to experience a less severe form of COVID-19 disease than adults, nevertheless, cases of severe infection have been described in a small proportion of patients, requiring hospitalization in 5-10% of cases. Among COVID-19 deaths 0,4% occurred in children and adolescents under 20 years of age. Most hospitalized children with acute COVID-19 had underlying conditions. Moreover, some children with previous COVID-19 infection, may later develop Multisystem Inflammatory Syndrome in Children (MIS-C), a rare but serious condition associated with COVID-19. These data suggest that a specific therapy is necessary in high-risk pediatric population, in order to prevent severe COVID-19, especially in children with underlying conditions. Antiviral paediatric data are currently very few Methods: We conducted a retrospective study on patients < 18 years of age who received Paxlovid (nirmatrelvir-ritonavir) for the treatment of mild-tomoderate COVID-19 at Bambino Gesu Children's Hospital from April 2022 to September 2022. Patients at high risk of progression to severe COVID-19 who had no need of supplemental oxygen received Paxlovid according to AIFA's indications for adults with the Informed Consent of relatives Results: 40 patients aged 1-18 years with confirmed SARS-CoV-2 infection were treated with Paxlovid (Tab 1)The average symptom duration was 4.2 days. No patient developed severe COVID-19 r All patients were treated within 5 days of symptom onset, Four patients received a longer course treatment (10 days) due to the persistence of symptoms combined with the presence of severe comorbidities .The mean time of viral shedding was 12.7 days, with a patient being persistently positive for 56 days. After Paxlovid initiation, only 5 patients (12.5%) experienced adverse reactions: Conclusion(s): Treatment with Paxlovid has proven to be safe. Further pharmacokinetic studies are required species for children < 5 years old.
ABSTRACT
Background. Since the start of the COVID-19 pandemic, Chad has had 7,417 confirmed cases and 193 deaths, one of the lowest in Africa. Objective. This study assessed SARS-CoV-2 immunity in N'Djamena. Methods. In August-October 2021, eleven N'Djamena hospitals col-lected outpatient data and samples. IgG antibodies against SARS-CoV-2 nucleocapsid protein were identified using ELISA. "Bambino Gesu" Laboratory, Rome, Italy, performed external quality control with chemiluminescence assay. Results. 25-34-year-old (35.2%) made up the largest age group at 31.9+/-12.6 years. 56.4% were women, 1.3 women/men. The 7th district had 22.5% and the 1st 22.3%. Housewives and students dominated. Overall seroprevalence was 69.5% (95% CI: 67.7-71.3), females 68.2% (65.8-70.5) and males 71.2% (68.6-73.8). >44-year-old had 73.9% seroprevalence. Under-15s were 57.4% positive. Housewives (70.9%), civil servants (71.5%), and health workers (9.7%) had the highest antibody positivity. N'Djamena's 9th district had 73.1% optimism and the 3rd district had 52.5%. Seroprevalences were highest at Good Samaritan Hospital (75.4%) and National General Referral Hospital (74.7%). Conclusion. Our findings indicate a high circulation of SARS-CoV-2 in N'Djamena, despite low mortality and morbidity after the first two COVID-19 pandemic waves. This high seroprevalence must be considered in Chad's vaccine policy.Copyright © 2022 The Authors and PAGEPRESS PUBLICATIONS.
ABSTRACT
Background. Since the start of the COVID-19 pandemic, Chad has had 7,417 confirmed cases and 193 deaths, one of the lowest in Africa. Objective. This study assessed SARS-CoV-2 immunity in N'Djamena. Methods. In August-October 2021, eleven N'Djamena hospitals col-lected outpatient data and samples. IgG antibodies against SARS-CoV-2 nucleocapsid protein were identified using ELISA. "Bambino Gesu" Laboratory, Rome, Italy, performed external quality control with chemiluminescence assay. Results. 25-34-year-old (35.2%) made up the largest age group at 31.9+/-12.6 years. 56.4% were women, 1.3 women/men. The 7th district had 22.5% and the 1st 22.3%. Housewives and students dominated. Overall seroprevalence was 69.5% (95% CI: 67.7-71.3), females 68.2% (65.8-70.5) and males 71.2% (68.6-73.8). >44-year-old had 73.9% seroprevalence. Under-15s were 57.4% positive. Housewives (70.9%), civil servants (71.5%), and health workers (9.7%) had the highest antibody positivity. N'Djamena's 9th district had 73.1% optimism and the 3rd district had 52.5%. Seroprevalences were highest at Good Samaritan Hospital (75.4%) and National General Referral Hospital (74.7%). Conclusion. Our findings indicate a high circulation of SARS-CoV-2 in N'Djamena, despite low mortality and morbidity after the first two COVID-19 pandemic waves. This high seroprevalence must be considered in Chad's vaccine policy. Copyright © 2022 The Authors and PAGEPRESS PUBLICATIONS.
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Background: It has been observed that lockdown restrictions during COVID-19 pandemic may have had a negative impact on HIV epidemic goals with disruption in care. We aim to analyse the trends in non-viral suppression for PLWH during and after the lockdown for COVID-19 pandemic in Italy compared to 2019. Methods: We included all participants in the ICONA cohort for whom there was ≥1 viral load (VL) in the window Nov 2019-Jan 2020 and with most recent VL≤50 copies/mL (exposed to lockdown), and over Nov 2018-Jan 2019 (not exposed). New enrolments in the study period were excluded. At population level and separately by year, we calculated proportion with VL≤50 copies/mL at each month over March-September and we performed an intermittent time series (ARIMA) model centred in March. In addition, we defined an individual outcome using the first VL over May-September (>50 vs. ≤50 copies/mL), comparing proportion with VL>50 copies/mL between exposed and not exposed by means of logistic regression models. PLWH with missing VL in the outcome window were excluded from the analysis. We also performed an alternative analysis in which censoring bias was minimised using inverse probability of weighting. Sensitivity analyses were performed after restricting to clinical sites with electronic linkage with laboratory data and to the subset of PLWH under follow-up in both years. Results: A total of 3,684 PLWH were included (2019=2,948;2020=736). PLWH exposed to lockdown were significantly older, less frequently MSM, non-Italian, had a higher CD4+ count and more frequently resident in north of Italy. The mean proportion of VL<50 copies/mL was 97% at March 2020 (ref.), 99% before March 2020, 82% at April 2020 (ARIMA estimates -21% 95% CI:-28%;-14%;P=0.01) and 97% after April 2020. In the 2019, the same proportions were 100%, 98%, 95%, and 97% with evidence for a lower drop in April (-6%, 95% CI:-8%;-3%, p=0.02). The results of the logistic regression model are reported in Table 1. When restricting to sites with electronic VL linkage and to those followed-up in both years the IPW OR of 2020 vs. 2019 were 1.23 (0.69-2.18) and 1.03 (0.48-2.19), respectively. Conclusion: We found little evidence for a difference in the proportion of PLWH with a VL>50 copies/mL, following stable suppression, in the period post lockdown due to COVID-19 as compared to the previous year. Although selection bias was minimized, reasons for a missing VL should be further investigated.
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Background: Lombardy region, Italy, has one of world's largest coronavirus disease 19 (COVID-19) outbreak with over 80,000 cases. Here, we report the incidence of SARS-CoV-2 infection in patients with active cancer at the Division of Oncology, Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, a comprehensive cancer institution in the capital of Lombardy, Milano. Patients and Methods: From April 15th to May 15th, 2020, SARS-CoV-2 testing has been performed in patients with active cancer by paired real time-PCR in nasopharyngeal swab (NPS) (Elitech, Torino, IT) and chemiluminescent immunoassays for detection of antiviral IgG in blood (Abbot, Sligo, IR or Diasorin, Saluggia, IT). Active cancer was defined as a solid tumor requiring anticancer treatment or supportive care. Tested patients were either outpatients with at least one suggestive symptom of COVID-19 assessed by telephone triage per local guidelines, or inpatients routinely tested at hospital admission, irrespective of symptoms. Additionally, patients with COVID-19 requiring hospitalization at Niguarda Hospital during the study period have been tested and results pooled for evaluating concordance of NPS with serology. Results: 118 patients were tested by NSP, and paired serology is available at the moment for 63 (53.4%). In the outpatient setting, 517 underwent telephone triage and 58 reported at least one symptom (11.2%). Of these, 3/29 and 3/14 (10.3 and 21.4%) tested positive on NSP and serology, respectively. In the cohort of inpatients, tested regardless of symptoms, 2/82 and 4/42 (2.4 and 9.5%) tested positive on NSP and serology, respectively. Finally, among oncology physicians, 2/34 and 2/34 (5.9%) tested positive on NSP and serology, respectively. 7 additional hospitalized patients displaying COVID-19 disease have been tested. Overall, the accuracy between NSP and serology was 82.5% and concordance was 0.415 (Cohen's k). In 5 cases, serology was positive and NSP negative, whereas the opposite was found in 6. Recruitment and testing are still ongoing at the moment of abstract submission and complete results will be presented. Conclusions: In our series of patients with active cancer during a peak period of the pandemic in Lombardy, 11% of outpatients displayed COVID-19 associated symptoms and 10% had positive NSP. Among inpatients tested regardless of symptoms, 2.4% had positive NSP. The accuracy between NSP and serology was 82.5%.